Week of __________________________
You might want to make copies of this form. Leave this one blank, so you can copy it as needed. Write in the exercises and activities
you plan to do. Create a schedule you think you really can manage. You can change your plan as your fitness improves and you are
able to do more.
(Make sure to check with your Doctor before starting any exercise program)
SOURCE: National Institutes of Health (www.nih.gov)